title: [The problem patient in dermatological practice. Psychomatic aspects (author's transl)].
abstract: In an exemplary case (44 year old female patient with pruritus) the priority of somatic aspects of an "organized disease" is questioned. The conception of a "total diagnosis" on the basis of a "pluriperspective complementary medicine" taking into consideration genetic, anatomic, physiologic, biochemical, microbiological, psychological and sociocultural facts is presented as the antithesis. Besides a somatic diagnosis the aim of medical procedure is the recognition ("reference diagnosis") of a "reference disturbance" in the doctor-patient relationship in which the "fundamental disturbance" of the patient is recalled from early childhood. This reference diagnosis can be learned by dermatologists and general practitioners in Balint groups.
mesh_terms: D000328:Adult; D003876:Dermatitis, Atopic / Q000523:psychology; D003937:Diagnosis, Differential; D004485:Eczema / Q000523:psychology; D005260:Female; D006801:Humans; D010817:Physician-Patient Relations; D011537:Pruritus / Q000175:diagnosis / Q000523:psychology*; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000523:psychology*
vernacular_title: Der Problempatient in der dermatologischen Praxis. Psychosomatische Aspekte.